Cancer - Kidney(구연) Oral Session 7 / Cancer - Kidney (Ⅰ) (O-075) Rm.201 10월 30일(수) 16:00-17:00 Association between kidney function, proteinuria and the risk of kidney cancer: A nationwide cohort study involving 10 million participants 을지대학병원 비뇨의학교실, 성균관의대 삼성서울병원 가정의학교실¹, 가톨릭대학교 서울성모병원 의학통계교실², 성균관의대 삼성서울병원 내과학교실,³ , 성균관의대 삼성서울병원 국제 건강센터⁴ 박진성, 신동욱¹, 한경도², 김다혜², 장혜련³, 전소현⁴ Purpose: While decreased renal function is a well-known risk factor of kidney cancer (KC), association of proteinuria with KC is unclear. In this large cohort study, we evaluated the risk of KC according to glomerular filtration rate (GFR) and dipstick proteinuria, as well as joint effects between the two. Methods: A total of 9,809,366 participants who participated in the nationwide health screening program in 2009 and did not have history of any cancer were included. The impact of GFR, dipstick proteinuria, and interactive associations of the two factors on the development of KC were analyzed. Results: During the median follow-up of 7.3 years, 10,634 participants developed KC (overall incidence rate: 14.9 per 100,000 person-years). Subjects with low GFR (<60 mL/min/1.73 m2) had a higher incidence of KC (adjusted hazard ratio [aHR] 1.26, 95% CI 1.18-1.34) than those with a high GFR (≥ 60). When GFR of 60-90 was considered the reference group, KC risk was higher in low GFR groups: GFR <30 (aHR 1.21) and GFR 30-60 group (aHR 1.27), while there was no decreased risk in higher GFR groups (GFR >90 or ≥ 120). A clear dose-response relationship was also found with the degree of dipstick proteinuria; compared to the no proteinuria group, even the trace group had an elevated risk of KC (aHR 1.20) and the risk increased more than double in the 4+ proteinuria group (aHR 2.15). Sensitivity analyses after excluding subjects with less than 2 years of follow-up showed consistent results. Analyses of joint effects of GFR and dipstick proteinuria showed that in the no proteinuria group, the increased incidence of KC was less evident with decreasing GFR, whereas in the proteinuria group, there was marked increase in KC incidence along with decreasing GFR (Fig 1). Conclusions: Low GFR and proteinuria were associated with future KC development, possibly in synergistic manner. Further research is warranted to develop strategies to reduce cancer risk in the chronic kidney disease population. keywords : kidney cancer, chronic kidney disease, proteinuria